Monday, July 27, 2009

The TRUTH -- Health Care Reform

I read this on Raymond's blog this morning - catching up on all those emails and blogs after having been gone for a week.

Here’s to your health, unless you are too old, too young, too disabled or any combination of the above. The health care reform bills wending their way through Congress should be focused on the well being of each citizen. Instead, it seems the bills, designed to contain costs while simultaneously extending health coverage to everyone, target certain vulnerable groups including the elderly, the pre-born, and the disabled. It all comes down to cost. How to pay for this colossus remains a question on the Hill. But the consensus seems to be: raise taxes and ration care. Both ideas have been woven into the current health care bills.


The elderly or people with catastrophic diseases are clearly in the sights of the Administration and the Congressional leadership for the simple reason that they cost too much. A quarter of all Medicare payments occur in the last year of life, costing the government more than 100 billion dollars a year according to Forbes Magazine.

I spoke this week with Betsy McCaughey, a patient advocate and former lieutenant governor of New York. Ms. McCaughey has actually read the various bills coming out of the House and Senate committees (which is more than one can say for most of the members of Congress). What she has found should give us pause. In a recent article, McCaughey wrote:

“One troubling provision of the House bill compels seniors to submit to a counseling session every five years (and more often if they become sick or go into a nursing home) about alternatives for end-of-life care (House bill, p. 425-430). The sessions cover highly sensitive matters such as whether to receive antibiotics and ‘the use of artificially administered nutrition and hydration.’ This mandate invites abuse, and seniors could easily be pushed to refuse care.”

This “Advance Care Planning Consultation” would encourage all of us, but especially those with severe illnesses to submit to hospices rather than pursue expensive therapies that might extend life (and cost a bundle). The bill also establishes a tracking system to insure that doctors are advocating “advance care directives” where you predetermine what type of care you would accept or refuse at the end of life. The problem with all of this is it assigns a utilitarian value to human life. If you are too old or disabled, there will be a built in incentive to push you into hospice and palliative care rather than work to beat the disease. Inexplicably, the AARP supports this provision. Talk about thinning your base…


Two House committees have rejected amendments banning the funding of abortion in the Health Care Reform bill. The way abortion funding works is: if it isn’t specifically banned, chances are it is covered.

If there are any doubts about where this Health Care Reform plan is headed, look at what happened in the Senate. On July 9th Senator Barbara Mikulski (D-Maryland) managed to pass an amendment that compels insurance providers to pay for “preventive care and screenings” for “pregnant women and women of child-bearing age.” This seems innocuous enough. But when Senator Orin Hatch (R-Utah) asked if the amendment would include abortion and funding for Planned Parenthood clinics, the answer was basically, yes. When Hatch suggested adding language that read: “not including abortion” he was rebuffed. His formal amendment to prohibit abortion funding in the Health Care Reform plan was also defeated in committee.

Remember: The “essential benefits package” covered by the government plan won’t be determined until AFTER the reform bill is passed. An amorphous “Advisory Committee” run by the pro-choice, Catholic, Secretary of Health and Human Services Kathleen Sebelius will establish benefits and covered treatments. Given the administration’s track record, it is hard to imagine that abortion would be excluded from coverage. For more on this hidden "Supreme Court of Health Care" check out David Broder's very good piece here:

[the entire article can be read here]

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